NPIMap

Organization Active NPI

Betsy Layne Primary Care, PLLC

Doing business as Floyd County Rural Health

  • Rural Health Clinic/Center
  • Minnie, KY
National Provider Identifier
1043988546
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BETSY LAYNE PRIMARY CARE, PLLC
Doing business as
Floyd County Rural Health
Practice address
8324 Ky Route 122
Minnie, KY 41651-9008
Phone
(606) 949-1727
Fax
(606) 949-1725
NPI assigned
Aug 31, 2021
Last updated
Jan 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Loren Mikale Kidd, NPNPI 1518356377
Title
Ao
Phone
(606) 949-1727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

8324 Ky Route 122
Minnie, KY 41651-9008

Mailing address

83 Short St
Betsy Layne, KY 41605-7041
Phone (606) 949-1727

Other names 1

  • Floyd County Rural Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220208000218 KY Part A Provider - Rural Health Clinic 7416219605 Practice locations: Minnie, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043988546. Details of each certification follow.

Rural health clinic certification: CCN B03895

Legal name
BETSY LAYNE PRIMARY CARE, PLLC
Doing business as
FLOYD COUNTY RURAL HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 23, 2022
Last certification
Aug 23, 2022
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
Aug 22, 2017 in KY
Enrollment address
8324 Ky Route 122
Minnie, KY 41651-9008

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Betsy Layne Primary Care PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Loren Kidd Individual 5% Or Greater Direct Ownership InterestOwner Nov 1, 2017 100%
Operational/Managerial ControlOwner Nov 1, 2017
Jordan Kidd Individual W-2 Managing EmployeeOffice Manager Nov 1, 2017
Operational/Managerial ControlOffice Manager Nov 1, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1043988546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SHORT ST",
            "city": "BETSY LAYNE",
            "state": "KY",
            "postal_code": "416057041",
            "telephone_number": "606-949-1727",
            "fax_number": "606-949-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8324 KY ROUTE 122",
            "city": "MINNIE",
            "state": "KY",
            "postal_code": "416519008",
            "telephone_number": "606-949-1727",
            "fax_number": "606-949-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETSY LAYNE PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "MIKALE",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "606-949-1727",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Floyd County Rural Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Floyd County Rural Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnie, KY

Sources for this page

Verify at the official NPI Registry.